The additional value of PET/CT over PET in FDG imaging of oesophageal cancer

  • Rachel Bar-Shalom
  • Ludmila Guralnik
  • Medy Tsalic
  • Max Leiderman
  • Alex Frenkel
  • Diana Gaitini
  • Alon Ben-Nun
  • Zohar Keidar
  • Ora Israel
Original Article
  • 230 Downloads

Abstract

Purpose

The aim of this study was to assess the value of combined PET/CT compared with PET reviewed side-by-side with CT, in patients with oesophageal cancer, before and after surgery.

Methods

Forty-one FDG PET/CT studies were performed in 32 patients with oesophageal cancer, before surgery (n=18) or during follow-up after resection of the primary tumour (n=23). One hundred and fifteen sites suspicious for malignancy were evaluated. PET/CT was prospectively compared with PET reviewed side-by-side with CT, for detection, accurate localisation and characterisation of malignant sites. PET/CT performance in different anatomical regions was compared before and after surgery. The impact of fused data on patient management was retrospectively assessed.

Results

PET/CT had an incremental value over PET for interpretation of 25 of 115 sites (22%), changing the initial characterisation of ten sites to either malignant (n=1) or benign (n=9), and defining the precise anatomical location of 15 sites. PET/CT provided better specificity and accuracy than PET for detecting sites of oesophageal cancer (81% and 90% vs 59% and 83% respectively, p<0.01). Fusion was of special value for interpretation of cervical and abdomino-pelvic sites, for disease assessment in loco-regional lymph nodes before surgery and in regions of postoperative anatomical distortion. PET/CT had an impact on the further management of four patients (10%), by detecting nodal metastases that warranted disease upstaging (n=2) and by excluding disease in sites of benign uptake after surgery (n=2).

Conclusion

PET/CT improves the accuracy of FDG imaging in oesophageal cancer and provides data of diagnostic and therapeutic significance for further patient management.

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Rachel Bar-Shalom
    • 1
  • Ludmila Guralnik
    • 2
  • Medy Tsalic
    • 3
  • Max Leiderman
    • 2
  • Alex Frenkel
    • 1
  • Diana Gaitini
    • 2
    • 4
  • Alon Ben-Nun
    • 5
  • Zohar Keidar
    • 1
    • 4
  • Ora Israel
    • 1
    • 4
  1. 1.Department of Nuclear MedicineRambam Medical CenterHaifaIsrael
  2. 2.Department of Diagnostic ImagingRambam Medical CenterHaifaIsrael
  3. 3.Department of OncologyRambam Medical CenterHaifaIsrael
  4. 4.Technion, Israel Institute of TechnologySchool of MedicineHaifaIsrael
  5. 5.Department of Thoracic SurgeryRambam Medical CenterHaifaIsrael

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